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General NPI Number Information
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NPI Number | 1336556414
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Entity Type | Individual
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Provider Name | RITA DENISE RIDDICK-SEELS
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Gender | Female
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Dates
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Enumeration Date | 07/21/2014
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Last Update Date | 12/04/2015
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Provider Practice Location Address
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Address Line | 9841 NORTHLAKE CENTRA PARKWAY
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City | CHARLOTTE
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State | NC
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Zip | 28216
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Country | US
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Telephone | 704-526-3648
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Fax |
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Provider Business Mailing Address
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Address Line | 3208 GRANDEUR RD
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City | CHARLOTTE
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State | NC
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Zip | 28269-3217
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Country | US
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Telephone | 704-766-1237
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RIDD-HMVE1U
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License Number State | NC
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